Pubertal gynecomastia is enlargement of glandular structure in breasts without existence of endocrine pathology in adolescent males. The aforementioned condition can be seen in both breasts as well as in only one. In addition, depending on an individual’s body, this situation may be painful. Physiological gynecomastia can manifest itself in any period of life. However, it is known that it is more common in neonatal period, adolescence period and late period of life.
Is pubertal gynecomastia, which is a nightmare of adolescent males, temporary? How is it noticed and how is it treated? All the details are in our article.
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Is Pubertal Gynecomastia Temporary?
Gynecomastia, which is known as breast enlargement in males, has different types in itself. Among these, pubertal gynecomastia is known as the most common type. It is more likely to be seen between the ages of 10 and 16 compared to other periods. It is especially likely to be seen at the age of 13-14.
The reason of breast enlargement in adolescent males is still unknown. Generally, there is no chronic condition, drug use or endocrinopathy that causes this condition.
Change in hormone level is estimated as the root cause of this problem. There is a distinct balance between estrogen and androgen hormones secreted for a healthy individual. It is estimated that gynecomastia develops with the deterioration of this balance. For example, sex hormone-binding globulin (SHBG) levels decrease in children who are overweight compared to normal. Accordingly, a significant increase occurs in estrogen level. The aforementioned situation creates a suitable environment for pubertal gynecomastia.
In the later periods of adolescence, a significant increase occurs in the release of testosterone hormone from testicles night and day. In this way, testosterone level increases and this situation provides regression of gynecomastia. According to this, most of gynecomastia cases seen in adolescence disappear spontaneously and no treatment is needed.
The ratio of spontaneously disappeared cases is around 90%. However, for 10%, pubertal gynecomastia becomes permanent and needs to be treated.
How to Understand Pubertal Gynecomastia?
Pubertal gynecomastia is usually not painful. Therefore, it can be said that related discomfort is generally noticed by chance. However, in some cases, pain can be seen and in such cases, existence of pubertal gynecomastia is identified depending on complaints.
In this case, growth and pain in breasts may not be symmetrical. In other words, while one breast grows, the other can remain in its normal size without growing. Likewise, pain can only be in one breast. Mostly, glandular tissue is smaller than 4 cm. While cases smaller than 4 cm usually regress spontaneously, there is no spontaneous regression in situations where glandular tissues larger than 5 cm (macro gynecomastia) exist.
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How Long Will It Take For Pubertal Gynecomastia To Recover Spontaneously?
In the essential part of pubertal gynecomastia cases, the disease starts to regress at the end of the first 6 months. 75% of patients recover within two years and 90% of patients spontaneously recover within three years. At this point, no treatment is needed.
Gynecomastia may continue for a long time (10%) in cases where a hormonal pathology cannot be determined. In such cases, resection can be considered. If an appropriate treatment method is not followed, it will be inevitable for that individual to experience different problems in social and in-group activities. This situation may confront people as a psychological problem in the future.
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How is Pubertal Gynecomastia Treated?
Breast enlargement in adolescent males is called pubertal gynecomastia when symptoms are not in question. Possibility for this situation being pathological is extremely high. Therefore, cases must be approached with great care and attention. When evaluating the disease, special attention should be paid to the following matters:
Congenital adrenal hyperplasia (11-beta hydroxylase defect)
Foods of animal origin that are treated with estrogen
Estrogen-containing creams and products used for hair
Growth hormone therapy
Increased aromatase enzyme activity
Drug use (digitals, cimetidine, reserpine etc.)
Adrenal and testicular tumors
Each of the mentioned matters here is in itself a cause of gynecomastia or constitutes a basis for this disease. Therefore, existence of such situations in cases has great importance for treatment planning. In addition, it has been understood that more than 300 drugs have been found to cause gynecomastia nowadays. Therefore, elimination of causes that result in this situation should be prioritized.
In general, 3 different approaches have been adopted in the treatment of pubertal gynecomastia. These approaches and their details are given below.
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If there is no underlying cause, it can be said that the main approach to be taken in treatment is observation. Because, in such cases, 90% of the cases disappeared by themselves without any treatment. Therefore, if there is no underlying cause, it is recommended to keep the person under observation for 3-6 months and to see whether gynecomastia regresses or not.
The main goal in this approach is to change estrogen and androgen ratios. It is recommended for patients with pain, tenderness and cosmetic problems in breast area although 1 year left behind after pubertal gynecomastia started. However, it should not be forgotten that there is no currently approved drug for this approach.
Fibrosis has developed in cases with macro gynecomastia that last for more than 4 years. Therefore, it can be stated that the most effective solution is surgical treatment.
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Selection of surgeon has great importance for pubertal gynecomastia. This problem can be overcome permanently with an expert and experienced surgeon. At this point, Cosmeticium will meet your expectations with its expert surgeons. You can contact Cosmeticium for more information related to the subject and take advantage of free online consultation opportunity.